Dorsal root ganglion stimulation for chemotherapy‐induced peripheral neuropathy

• Published in: Pain practice 2023-09, Vol.23 (7), p.793-799
• Main Authors: Ege, Eliana, Briggi, Daniel, Mach, Steven, Huh, Billy K., Javed, Saba
• Format: Article
• Language: English
• Subjects: cancer; chemotherapy; dorsal root ganglion; polyneuropathy; refractory pain; spinal cord stimulation
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.13259

Background Chemotherapy‐induced peripheral neuropathy (CIPN) is a common consequence of cancer treatment that can be persistent and difficult to manage. Dorsal root ganglion stimulation (DRG‐S) is a recently introduced but understudied treatment modality. This study explored the effect of DRG‐S on pain and symptom burden associated with CIPN. Methods Patients with CIPN who underwent a DRG‐S trial between January 2017 and August 2022 were identified through chart review after IRB approval was obtained. Demographic data, procedure details, pre‐and postoperative scores, including the Numerical Rating Scale (NRS) and Edmonton Symptom Assessment System (ESAS), and duration of follow‐up were recorded. Statistical analysis included descriptive statistics and paired t‐tests to compare pre‐and postoperative scores. Results Nine patients with an even mix of solid and hematologic malignancies underwent DRG‐S trial and had a statistically significant decrease in NRS scores, with a mean reduction of 2.3 in their average pain (p = 0.014), 2.6 in worst pain (p = 0.023), and 2.1 in least pain (p = 0.018). Eight patients (88.9%) underwent permanent DRG‐S implantation. Mean NRS scores remained lower than preoperative baselines through the first year of follow‐up. Statistically significant reductions were noted at 3 months in average (2.1, p = 0.006) and least pain scores (1.9, p = 0.045), which further decreased after 6–12 months (average: 3.6, p = 0.049; least: 3.4, p = 0.023). Only the pain component of ESAS scores showed a significant reduction with DRG‐S (2.0, p = 0.021). All patients endorsed improved sensation, 75% decreased their pain medication usage, and 37.5% reported complete pain relief by 2 years. Conclusion Dorsal root ganglion stimulation can be an effective treatment for pain related to CIPN and deserves further investigation.